{"id":"https://openalex.org/W7202287508","doi":"https://doi.org/10.1044/2026_jslhr-25-00824","title":"Explanatory Sequential Mixed-Methods Study of the Effectiveness of the Childhood Dysphagia Management Scale (CDMS): Part 2 of a CDMS Hybrid Effectiveness\u2013Implementation Study","display_name":"Explanatory Sequential Mixed-Methods Study of the Effectiveness of the Childhood Dysphagia Management Scale (CDMS): Part 2 of a CDMS Hybrid Effectiveness\u2013Implementation Study","publication_year":2026,"publication_date":"2026-08-12","ids":{"openalex":"https://openalex.org/W7202287508","doi":"https://doi.org/10.1044/2026_jslhr-25-00824","pmid":"https://pubmed.ncbi.nlm.nih.gov/42584977"},"language":"en","primary_location":{"id":"doi:10.1044/2026_jslhr-25-00824","doi":"https://doi.org/10.1044/2026_jslhr-25-00824","is_oa":false,"landing_page_url":"https://doi.org/10.1044/2026_jslhr-25-00824","pdf_url":null,"source":{"id":"https://openalex.org/S110744938","display_name":"Journal of Speech Language and Hearing Research","issn_l":"1092-4388","issn":["1092-4388","1558-9102"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","ccf-b","cwts-core","dongbi-d","doyens","erih-plus","jufo-3","ki-jl-1","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320281","host_organization_name":"American Speech\u2013Language\u2013Hearing Association","host_organization_lineage":["https://openalex.org/P4310320281"],"host_organization_lineage_names":["American Speech\u2013Language\u2013Hearing Association"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Speech, Language, and Hearing Research","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5044023127","display_name":"Jennifer L. Maybee","orcid":"https://orcid.org/0000-0003-4665-6630","observed_orcids":["https://orcid.org/0000-0003-4665-6630"]},"institutions":[{"id":"https://openalex.org/I4210096275","display_name":"Children's Hospital Colorado","ror":"https://ror.org/00mj9k629","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210096275"]},{"id":"https://openalex.org/I921990950","display_name":"University of Colorado Denver","ror":"https://ror.org/02hh7en24","country_code":"US","type":"education","lineage":["https://openalex.org/I921990950"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jennifer Maybee","raw_affiliation_strings":["Children's Hospital Colorado, Aurora","Department of Physical Medicine and Rehabilitation, School of Medicine, University of Colorado Denver"],"raw_orcid":"https://orcid.org/0000-0003-4665-6630","affiliations":[{"raw_affiliation_string":"Children's Hospital Colorado, Aurora","institution_ids":["https://openalex.org/I4210096275"]},{"raw_affiliation_string":"Department of Physical Medicine and Rehabilitation, School of Medicine, University of Colorado Denver","institution_ids":["https://openalex.org/I921990950"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5007182575","display_name":"Emily M. DeBoer","orcid":"https://orcid.org/0000-0002-0924-9342","observed_orcids":["https://orcid.org/0000-0002-0924-9342"]},"institutions":[{"id":"https://openalex.org/I4210096275","display_name":"Children's Hospital Colorado","ror":"https://ror.org/00mj9k629","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210096275"]},{"id":"https://openalex.org/I921990950","display_name":"University of Colorado Denver","ror":"https://ror.org/02hh7en24","country_code":"US","type":"education","lineage":["https://openalex.org/I921990950"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Emily DeBoer","raw_affiliation_strings":["Children's Hospital Colorado, Aurora","Department of Pediatric Pulmonary and Sleep Medicine, School of Medicine, University of Colorado Denver"],"raw_orcid":"https://orcid.org/0000-0002-0924-9342","affiliations":[{"raw_affiliation_string":"Children's Hospital Colorado, Aurora","institution_ids":["https://openalex.org/I4210096275"]},{"raw_affiliation_string":"Department of Pediatric Pulmonary and Sleep Medicine, School of Medicine, University of Colorado Denver","institution_ids":["https://openalex.org/I921990950"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5018390287","display_name":"Emily Cooper","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I51713134","display_name":"University of Colorado Anschutz","ror":"https://ror.org/03wmf1y16","country_code":"US","type":"education","lineage":["https://openalex.org/I51713134"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Emily Cooper","raw_affiliation_strings":["Child Health Biostatistics Core University of Colorado Anschutz Medical Campus"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Child Health Biostatistics Core University of Colorado Anschutz Medical Campus","institution_ids":["https://openalex.org/I51713134"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5027741427","display_name":"John T. Brinton","orcid":"https://orcid.org/0000-0003-3310-0422","observed_orcids":["https://orcid.org/0000-0003-3310-0422"]},"institutions":[{"id":"https://openalex.org/I4210096275","display_name":"Children's Hospital Colorado","ror":"https://ror.org/00mj9k629","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210096275"]},{"id":"https://openalex.org/I921990950","display_name":"University of Colorado Denver","ror":"https://ror.org/02hh7en24","country_code":"US","type":"education","lineage":["https://openalex.org/I921990950"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"John T. Brinton","raw_affiliation_strings":["Children's Hospital Colorado, Aurora","Department of Pediatric Pulmonary and Sleep Medicine, School of Medicine, University of Colorado Denver"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Children's Hospital Colorado, Aurora","institution_ids":["https://openalex.org/I4210096275"]},{"raw_affiliation_string":"Department of Pediatric Pulmonary and Sleep Medicine, School of Medicine, University of Colorado Denver","institution_ids":["https://openalex.org/I921990950"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5063005142","display_name":"Juliana G. Barnard","orcid":"https://orcid.org/0000-0001-7814-9401","observed_orcids":["https://orcid.org/0000-0001-7814-9401"]},"institutions":[{"id":"https://openalex.org/I921990950","display_name":"University of Colorado Denver","ror":"https://ror.org/02hh7en24","country_code":"US","type":"education","lineage":["https://openalex.org/I921990950"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Juliana G. Barnard","raw_affiliation_strings":["Qualitative &amp; Mixed Methods (QM2) Research Core, Adult &amp; Child Center for Outcomes Research &amp; Delivery Science, University of Colorado Denver"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Qualitative &amp; Mixed Methods (QM2) Research Core, Adult &amp; Child Center for Outcomes Research &amp; Delivery Science, University of Colorado Denver","institution_ids":["https://openalex.org/I921990950"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5067287714","display_name":"Jeremy D. Prager","orcid":"https://orcid.org/0000-0002-8123-2529","observed_orcids":["https://orcid.org/0000-0002-8123-2529"]},"institutions":[{"id":"https://openalex.org/I4210096275","display_name":"Children's Hospital Colorado","ror":"https://ror.org/00mj9k629","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210096275"]},{"id":"https://openalex.org/I921990950","display_name":"University of Colorado Denver","ror":"https://ror.org/02hh7en24","country_code":"US","type":"education","lineage":["https://openalex.org/I921990950"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jeremy Prager","raw_affiliation_strings":["Children's Hospital Colorado, Aurora","Department of Pediatric Otolaryngology, University of Colorado Denver"],"raw_orcid":"https://orcid.org/0000-0002-8123-2529","affiliations":[{"raw_affiliation_string":"Children's Hospital Colorado, Aurora","institution_ids":["https://openalex.org/I4210096275"]},{"raw_affiliation_string":"Department of Pediatric Otolaryngology, University of Colorado Denver","institution_ids":["https://openalex.org/I921990950"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5141264475","display_name":"Arwen Jackson","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210096275","display_name":"Children's Hospital Colorado","ror":"https://ror.org/00mj9k629","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210096275"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Arwen Jackson","raw_affiliation_strings":["Children's Hospital Colorado, Aurora"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Children's Hospital Colorado, Aurora","institution_ids":["https://openalex.org/I4210096275"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.57482351,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"69","issue":"9","first_page":"4200","last_page":"4221"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11358","display_name":"Dysphagia Assessment and Management","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/3616","display_name":"Speech and Hearing"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11358","display_name":"Dysphagia Assessment and Management","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/3616","display_name":"Speech and Hearing"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10629","display_name":"Health Policy Implementation Science","score":0.0017000000225380063,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11744","display_name":"Health Sciences Research and Education","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/pediatric-dysphagia","display_name":"pediatric dysphagia","score":0.9929999709129333},{"id":"https://openalex.org/keywords/dysphagia-management","display_name":"dysphagia management","score":0.7120000123977661},{"id":"https://openalex.org/keywords/outcome-measurement","display_name":"outcome measurement","score":0.4099999964237213},{"id":"https://openalex.org/keywords/referral-rates","display_name":"referral rates","score":0.5889999866485596},{"id":"https://openalex.org/keywords/follow-up-care","display_name":"follow-up care","score":0.9950000047683716},{"id":"https://openalex.org/keywords/implementation","display_name":"implementation","score":0.39100000262260437},{"id":"https://openalex.org/keywords/down-syndrome","display_name":"Down syndrome","score":0.6740000247955322},{"id":"https://openalex.org/keywords/children-s-hospitals","display_name":"children's hospitals","score":0.44699999690055847},{"id":"https://openalex.org/keywords/family-burden","display_name":"family burden","score":0.5180000066757202},{"id":"https://openalex.org/keywords/service-duplication","display_name":"service duplication","score":0.6639999747276306}],"concepts":[{"id":"https://openalex.org/C2780596822","wikidata":"https://www.wikidata.org/wiki/Q623289","display_name":"Dysphagia","level":2,"score":0.7184000015258789},{"id":"https://openalex.org/C2778755073","wikidata":"https://www.wikidata.org/wiki/Q10858537","display_name":"Scale (ratio)","level":2,"score":0.5212000012397766},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.5055999755859375},{"id":"https://openalex.org/C143095724","wikidata":"https://www.wikidata.org/wiki/Q515895","display_name":"Odds","level":3,"score":0.49480000138282776},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.4846000075340271},{"id":"https://openalex.org/C2778979077","wikidata":"https://www.wikidata.org/wiki/Q330190","display_name":"Receipt","level":2,"score":0.4311999976634979},{"id":"https://openalex.org/C87156501","wikidata":"https://www.wikidata.org/wiki/Q7268708","display_name":"Qualitative property","level":2,"score":0.4244000017642975},{"id":"https://openalex.org/C199521495","wikidata":"https://www.wikidata.org/wiki/Q181487","display_name":"Audit","level":2,"score":0.42309999465942383},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.4219000041484833},{"id":"https://openalex.org/C2776135927","wikidata":"https://www.wikidata.org/wiki/Q5242559","display_name":"Referral","level":2,"score":0.40689998865127563},{"id":"https://openalex.org/C156393514","wikidata":"https://www.wikidata.org/wiki/Q6934800","display_name":"Multimethodology","level":2,"score":0.38510000705718994},{"id":"https://openalex.org/C17923572","wikidata":"https://www.wikidata.org/wiki/Q7250160","display_name":"Propensity score matching","level":2,"score":0.3741999864578247},{"id":"https://openalex.org/C165064840","wikidata":"https://www.wikidata.org/wiki/Q1321061","display_name":"Matching (statistics)","level":2,"score":0.3714999854564667},{"id":"https://openalex.org/C87227347","wikidata":"https://www.wikidata.org/wiki/Q7100713","display_name":"Ordered logit","level":2,"score":0.36390000581741333},{"id":"https://openalex.org/C83849319","wikidata":"https://www.wikidata.org/wiki/Q7295720","display_name":"Rating scale","level":2,"score":0.35929998755455017},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.35600000619888306},{"id":"https://openalex.org/C110313322","wikidata":"https://www.wikidata.org/wiki/Q7100793","display_name":"Ordinal regression","level":2,"score":0.3472999930381775},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.33980000019073486},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.325300008058548},{"id":"https://openalex.org/C19875794","wikidata":"https://www.wikidata.org/wiki/Q1207340","display_name":"Item response theory","level":3,"score":0.32440000772476196},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.3239000141620636},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.32100000977516174},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.3179999887943268},{"id":"https://openalex.org/C5395021","wikidata":"https://www.wikidata.org/wiki/Q1061410","display_name":"Program evaluation","level":2,"score":0.30410000681877136},{"id":"https://openalex.org/C71405471","wikidata":"https://www.wikidata.org/wiki/Q757012","display_name":"Quality management","level":3,"score":0.2964000105857849},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.295199990272522},{"id":"https://openalex.org/C177212765","wikidata":"https://www.wikidata.org/wiki/Q627335","display_name":"Workflow","level":2,"score":0.2775000035762787},{"id":"https://openalex.org/C2984752397","wikidata":"https://www.wikidata.org/wiki/Q3259956","display_name":"Primary care","level":2,"score":0.27160000801086426},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.2596000134944916},{"id":"https://openalex.org/C70410870","wikidata":"https://www.wikidata.org/wiki/Q199906","display_name":"Clinical psychology","level":1,"score":0.2508000135421753}],"mesh":[{"descriptor_ui":"D000293","descriptor_name":"Adolescent","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002675","descriptor_name":"Child, Preschool","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003680","descriptor_name":"Deglutition Disorders","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D003680","descriptor_name":"Deglutition Disorders","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007223","descriptor_name":"Infant","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012017","descriptor_name":"Referral and Consultation","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017063","descriptor_name":"Outcome Assessment, Health Care","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1044/2026_jslhr-25-00824","doi":"https://doi.org/10.1044/2026_jslhr-25-00824","is_oa":false,"landing_page_url":"https://doi.org/10.1044/2026_jslhr-25-00824","pdf_url":null,"source":{"id":"https://openalex.org/S110744938","display_name":"Journal of Speech Language and Hearing Research","issn_l":"1092-4388","issn":["1092-4388","1558-9102"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","ccf-b","cwts-core","dongbi-d","doyens","erih-plus","jufo-3","ki-jl-1","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320281","host_organization_name":"American Speech\u2013Language\u2013Hearing Association","host_organization_lineage":["https://openalex.org/P4310320281"],"host_organization_lineage_names":["American Speech\u2013Language\u2013Hearing Association"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Speech, Language, and Hearing Research","raw_type":"journal-article"},{"id":"pmid:42584977","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42584977","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of speech, language, and hearing research : JSLHR","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320309583","display_name":"Children's Hospital Colorado","ror":"https://ror.org/00mj9k629"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":28,"referenced_works":["https://openalex.org/W2020155291","https://openalex.org/W2028764578","https://openalex.org/W2093274439","https://openalex.org/W2112645786","https://openalex.org/W2120079020","https://openalex.org/W2170754611","https://openalex.org/W2465732231","https://openalex.org/W2793866202","https://openalex.org/W2794252728","https://openalex.org/W2907599501","https://openalex.org/W2909762065","https://openalex.org/W2944434778","https://openalex.org/W2966892607","https://openalex.org/W2967266139","https://openalex.org/W3048594033","https://openalex.org/W3123192473","https://openalex.org/W3152545136","https://openalex.org/W3157787291","https://openalex.org/W4205330902","https://openalex.org/W4214711902","https://openalex.org/W4237822883","https://openalex.org/W4283067053","https://openalex.org/W4294286377","https://openalex.org/W4307846395","https://openalex.org/W4384120612","https://openalex.org/W4391312768","https://openalex.org/W4391840394","https://openalex.org/W7170192039"],"related_works":["https://openalex.org/W7170192039","https://openalex.org/W3152545136","https://openalex.org/W2164193504","https://openalex.org/W7129061714","https://openalex.org/W187191335","https://openalex.org/W7204199849","https://openalex.org/W4417261992","https://openalex.org/W4400204831","https://openalex.org/W7163133017","https://openalex.org/W4411504206"],"abstract_inverted_index":{"Purpose:":[0],"As":[1],"Part":[2],"2":[3],"of":[4,15,96,192,207,255,296],"a":[5,22,63,284],"Type":[6],"1":[7],"hybrid":[8],"effectiveness\u2013implementation":[9],"study,":[10],"we":[11],"evaluated":[12,102],"the":[13,16,38,70,164,238,243,277],"effectiveness":[14,61],"Childhood":[17],"Dysphagia":[18],"Management":[19],"Scale":[20],"(CDMS),":[21],"validated":[23],"pediatric":[24],"dysphagia":[25,97,258,303],"outcomes":[26],"assessment":[27],"completed":[28],"by":[29,37],"therapists":[30,153],"following":[31,71],"instrumental":[32],"swallow":[33],"assessments.":[34],"Method:":[35],"Guided":[36],"Reach,":[39],"Effectiveness,":[40],"Adoption,":[41],"Implementation,":[42],"and":[43,45,78,94,112,137,141,152,175,190,226,248,251,272,279,298,310],"Maintenance":[44],"Consolidated":[46],"Framework":[47],"for":[48,93,103,123,257,269,302],"Implementation":[49],"Research":[50],"implementation":[51,107,114],"science":[52],"frameworks,":[53],"mixed":[54],"methods":[55],"were":[56,101,121,129,143,169],"used":[57],"to":[58,158,182,261],"evaluate":[59],"CDMS":[60,211,224,239,278],"in":[62,163,237,246,283],"tertiary":[64],"care":[65,100,194,228,250,260,301],"children's":[66,286],"hospital":[67,287],"system":[68,288],"across":[69,135],"areas:":[72],"general/workflow,":[73],"referrals,":[74],"follow-up":[75,99,193,227,249,300],"care,":[76],"communication,":[77],"patient/caregiver":[79],"impact.":[80],"Using":[81],"an":[82,290],"explanatory":[83],"sequential":[84],"design,":[85],"quantitative":[86,165,178],"results":[87],"informed":[88],"qualitative":[89,173],"interview":[90],"guides.":[91],"Referrals":[92],"receipt":[95,191],"management":[98,259],"patients":[104,124],"seen":[105],"pre\u2013CDMS":[106],"(":[108,115,148,154,214],"n":[109,116,149,155],"=":[110,117,150,156,197],"533)":[111],"post\u2013CDMS":[113,183],"594).":[118],"Separate":[119],"analyses":[120],"conducted":[122,144],"with":[125,145,177,219],"Down":[126,220],"syndrome.":[127],"Results":[128],"modeled":[130],"via":[131],"ordinal":[132],"logistic":[133],"regression":[134],"patient-level":[136],"contextual":[138],"factors.":[139],"Surveys":[140],"interviews":[142],"referring":[146],"providers":[147],"17)":[151],"35)":[157],"explore":[159],"knowledge":[160],"gaps":[161],"revealed":[162,231],"analysis.":[166],"Qualitative":[167,305],"data":[168],"analyzed":[170],"using":[171],"rapid":[172],"analysis":[174],"integrated":[176],"data.":[179],"Results:":[180],"Pre\u2013":[181],"implementation,":[184],"referrals":[185,208,247,297],"(28.7%\u201373.6%,":[186],"p":[187,196,215],"<":[188,216],".001)":[189],"(57%\u201363%,":[195],".067)":[198],"increased.":[199],"Patients":[200,218],"had":[201,222],"9.8":[202],"(7.31\u201313.29)":[203],"times":[204],"greater":[205],"odds":[206],"matching":[209],"their":[210],"score":[212],"post-implementation":[213],".001).":[217],"syndrome":[221],"higher":[223],"scores":[225],"needs.":[229],"Interviews":[230],"critical":[232],"insights":[233],"about":[234],"mechanisms":[235],"involved":[236],"workflow":[240,282],"that":[241,293],"supported":[242],"observed":[244],"improvements":[245],"also":[252],"brought":[253],"areas":[254],"challenge":[256],"light":[262],"such":[263],"as":[264],"access,":[265],"process":[266,292],"dissemination,":[267],"risk":[268],"service":[270],"duplication,":[271],"family":[273],"burden.":[274],"Conclusions:":[275],"Implementing":[276],"its":[280],"associated":[281],"large":[285],"provided":[289],"objective":[291],"increased":[294],"frequency":[295],"improved":[299],"management.":[304],"inquiry":[306],"illuminated":[307],"mechanisms,":[308],"barriers,":[309],"facilitators.":[311],"Supplemental":[312],"Material:":[313],"https://doi.org/10.23641/asha.33180143":[314]},"counts_by_year":[],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2026-08-13T00:00:00"}
